Effects of supervised exercise training during pregnancy on psychological well-being among overweight and obese women: secondary analyses of the ETIP-trial, a randomised controlled trial

Abstract

ObjectivesWomen with high body mass index (BMI) have increased risk for symptoms of anxiety and depression during pregnancy and postpartum. In this prespecified secondary analysis from the exercise training in pregnancy trial, our aim was to examine effects of supervised exercise during pregnancy on psychological well-being in late pregnancy and postpartum among women with a prepregnancy BMI ≥28 kg/m2.DesignSingle-centre, parallel group, randomised controlled trial.SettingUniversity Hospital, Norway.ParticipantsNinety-one women (age 31.2±4.1 years, BMI 34.5±4.2 kg/m2), 46 in the exercise group, 45 in the control group, were included in the trial.InterventionThe exercise group was offered 3 weekly supervised exercise sessions (35 min of moderate intensity walking/running and 25 min of resistance training), until delivery.Primary and secondary outcomes measuresPrimary analyses were based on intention to treat, with secondary perprotocol analyses. To assess psychological well-being, we used the ‘Psychological General Well-Being Index’ (PGWBI) at inclusion (gestational week 12–18), late pregnancy (gestational week 34–37) and 3 months postpartum. We assessed postpartum depression using the ‘Edinburgh Postnatal Depression Scale’ (EPDS).ResultsNumbers completed data collection: late pregnancy 72 (exercise 38, control 36), postpartum 70 (exercise 36, control 34). In the exercise group, 50% adhered to the exercise protocol. Baseline PGWBI for all women was 76.4±12.6. Late pregnancy PGWBI; exercise 76.6 (95% CI 72.2 to 81.0), control 74.0 (95% CI 69.4 to 78.5) (p=0.42). Postpartum PGWBI; exercise 85.4 (95% CI 81.9 to 88.8), control 84.6 (95% CI 80.8 to 88.4) (with no between-group difference, p=0.77). There was no between-group difference in EPDS; exercise 2.96 (95% CI 1.7 to 4.2), control 3.48 (95% CI 2.3 to 4.7) (p=0.55).ConclusionsWe found no effect of supervised exercise during pregnancy on psychological well-being among women with high BMI. Our findings may be hampered by low adherence to the exercise protocol.Trial registration number NCT01243554

The Effects of Tai Chi and Qigong Exercise on Psychological Status in Adolescents: A Systematic Review and Meta-Analysis

“…Currently, many studies have suggested that physical exercise, as an alternative and complimentary therapy, has a positive effect on psychological health (Tsang et al, 2008 ; Chen et al, 2012 ; Li et al, 2015 ; Epps et al, 2019 ; Garnaes et al, 2019 ). Qigong exercise is an easily adaptable form of mind-body integrative exercise whose basic components include thoughts concentration, relaxation, meditation, breathing regulation, body posture, and gentle movement (Tsang et al, 2002 ).…”

Current Research Trends, Hotspots, and Frontiers of Physical Activity during Pregnancy: A Bibliometric Analysis

“…Noticeably, a quick rise in blood pressure and intra-abdominal pressure is triggered by heavy strength training during pregnancy, which may momentarily reduce blood flow to the fetus. However, resistance exercise with a modest to moderate load had no negative consequences during pregnancy [ 40 ]. Resistance exercise with elastic belts for 2–3 repetitive sets of movements, or through self-muscle exercises that involve upper and lower limbs for 2–3 sets of 12–24 repetitions, would fit well in pregnancy [ 41 ].…”

Physical activity and pregnancy related health outcomes in overweight and obese pregnant women: A systematic review and meta-analysis

“…Of these, full-text articles for 62 references were assessed for eligibility to be included in the study. The final articles included for the review are 12 studies [10][11][12][13][14][15][16][17][18][19][20][21]. Meta-analysis study includes 11 RCTs out of 12, and one study was excluded due to unfitting data for measurement of outcomes [10].…”

“…All the studies included for analysis were published between the years 2011 and 2019 in English as shown in Table 1. Most of the randomized controlled trial is conducted in a developed country; three in Norway [10][11][12], three in Spain [13,17,19], and each one study in Ireland [15], New Zealand [18], United States [20], and the Netherlands [16], while the remaining two studies are conducted in developing countries; each one study in China [14] and Brazil [21]. In terms of the author, Garnaes et al was the author of three studies, and each of the studies was analyzed as an individual study because they measured several different outcomes and the studies are published in a different time [10][11][12].…”

“…Six studies do not describe in detail the allocation concealment, and two [15,21] studies reported that the sequence was randomly distributed in opaque envelopes, which were sealed and sequentially numbered. The remaining four [10][11][12]18] studies mentioned that the allocation results were received by the study investigators that do not have access to a full randomization list in order to maintain the allocation concealment.…”